SOUTH CENTRAL REGIONAL MEDICAL CENTER Laurel, Mississippi

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1 SOUTH CENTRAL REGIONAL MEDICAL CENTER Laurel, Mississippi Report on Compliance in Accordance with the Uniform Guidance For the Year Ended September 30, 2017

2 CONTENTS Report on Compliance for Each Major Federal Program; Report on Internal Control Over Compliance; and Report on Schedule of Expenditures of Federal Awards Required by the Uniform Guidance 1 2 Schedule of Expenditures of Federal Awards and tes to the Schedule of Expenditures of Federal Awards 3 Schedule of Findings and Questioned Costs 4 Summary Schedule of Prior Year Audit Findings 5

3 REPORT ON COMPLIANCE FOR EACH MAJOR FEDERAL PROGRAM; REPORT ON INTERNAL CONTROL OVER COMPLIANCE; AND REPORT ON SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS REQUIRED BY THE UNIFORM GUIDANCE Board of Trustees South Central Regional Medical Center Laurel, Mississippi Report on Compliance for Each Major Federal Program We have audited South Central Regional Medical Center's (the "Medical Center") compliance with the types of compliance requirements described in the OMB Compliance Supplement that could have a direct and material effect on each of the Medical Center's major federal programs for the year ended September 30, The Medical Center's major federal programs are identified in the summary of auditor's results section of the accompanying schedule of findings and questioned costs. Management's Responsibility Management is responsible for compliance with federal statutes, regulations, and the terms and conditions of its federal awards applicable to its federal program. Auditor's Responsibility Our responsibility is to express an opinion on compliance for each of the Medical Center's major federal programs based on our audit of the types of compliance requirements referred to above. We conducted our audit of compliance in accordance with auditing standards generally accepted in the United States of America; the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States; and the audit requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards ("Uniform Guidance"). Those standards and Uniform Guidance require that we plan and perform the audit to obtain reasonable assurance about whether noncompliance with the types of compliance requirements referred to above that could have a direct and material effect on a major federal program occurred. An audit includes examining, on a test basis, evidence about the Medical Center's compliance with those requirements and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion on compliance for each major federal program. However, our audit does not provide a legal determination of the Medical Center's compliance. Opinion on Each Major Federal Program In our opinion the Medical Center complied, in all material respects, with the types of compliance requirements referred to above that could have a direct and material effect on each of its major federal programs for the year ended September 30, 2017.

4 Report on Internal Control Over Compliance Management of the Medical Center is responsible for establishing and maintaining effective internal control over compliance with the types of compliance requirements referred to above. In planning and performing our audit of compliance, we considered the Medical Center's internal control over compliance with the types of requirements that could have a direct and material effect on each major federal program to determine the auditing procedures that are appropriate in the circumstances for the purpose of expressing an opinion on compliance for each major federal program and to test and report on internal control over compliance in accordance with Uniform Guidance, but not for the purpose of expressing an opinion on the effectiveness of internal control over compliance. Accordingly, we do not express an opinion on the effectiveness of the Medical Center's internal control over compliance. A deficiency in internal control over compliance exists when the design or operation of a control over compliance does not allow management or employees, in the normal course of performing their assigned functions, to prevent, or detect and correct, noncompliance with a type of compliance requirement of a federal program on a timely basis. A material weakness in internal control over compliance is a deficiency, or combination of deficiencies, in internal control over compliance, such that there is a reasonable possibility that material noncompliance with a type of compliance requirement of a federal program will not be prevented, or detected and corrected, on a timely basis. A significant deficiency in internal control over compliance is a deficiency, or a combination of deficiencies, in internal control over compliance with a type of compliance requirement of a federal program that is less severe than a material weakness in internal control over compliance, yet important enough to merit attention by those charged with governance. Our consideration of internal control over compliance was for the limited purpose described in the first paragraph of this section and was not designed to identify all deficiencies in internal control over compliance that might be material weaknesses or significant deficiencies. We did not identify any deficiencies in internal control over compliance that we consider to be material weaknesses. However, material weaknesses may exist that have not been identified. The purpose of this report on internal control over compliance is solely to describe the scope of our testing of internal control over compliance and the results of that testing based on the requirements of the Uniform Guidance. Accordingly, this report is not suitable for any other purposes. Report on Schedule of Expenditures of Federal Awards Required by Uniform Guidance We have audited the financial statements of the Medical Center as of and for the year ended September 30, 2017, and have issued our report thereon dated vember 28, 2017, which contained an unmodified opinion on those financial statements as a whole. Our audit was conducted for the purpose of forming an opinion on the financial statements as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by the Uniform Guidance and is not a required part of the financial statements. Such information is the responsibility of management and was derived from and relates directly to the underlying accounting and other records used to prepare the financial statements. The information has been subjected to the auditing procedures applied in the audit of the financial statements and certain other procedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the financial statements or to the financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the schedule of expenditures of federal awards is fairly stated in all material respects in relation to the financial statements as a whole. Ridgeland, Mississippi vember 28,

5 SOUTH CENTRAL REGIONAL MEDICAL CENTER Schedule of Expenditures of Federal Awards and tes to the Schedule of Expenditures of Federal Awards Year Ended September 30, 2017 Federal Federal Grantor/Pass-Through CFDA Pass-Through Entity Federal Grantor/Program Title Number Identifying Number Expenditures United States Department of Agriculture Rural Development Direct programs: Community Facilities Loans and Grants N/A $ 30,792,220 Total expenditures of federal awards $ 30,792,220 NOTES TO SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS te 1. Basis of Presentation The accompanying schedule of expenditures of federal awards ("the Schedule") includes the federal grant activity of South Central Regional Medical Center (the "Medical Center") under programs of the federal government for the year ended September 30, The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards ("Uniform Guidance"). Because the Schedule presents only a selected portion of the operations of the Medical Center, it is not intended to and does not present the net position, changes in net position, or cash flows of the Medical Center. te 2. Summary of Significant Accounting Policies Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. 3

6 SOUTH CENTRAL REGIONAL MEDICAL CENTER Schedule of Findings and Questioned Costs Year Ended September 30, 2017 Section I - Summary of Auditor's Results Financial Statements Type of auditor's report issued Internal control over financial reporting: Material weakness(es) identified? Significant deficiency(ies) identified? ncompliance material to financial statements noted? Unmodified ne reported Federal Awards Internal control over major programs material weakness(es) identified? Significant deficiency(ies) identified? Type of auditor's report issued on compliance for major federal programs Any audit findings disclosed that are required to be reported in accordance with section 2 CFR (a)? ne reported Unmodified Identification of major programs: Federal CFDA Numbers Name of Federal Program or Cluster Community Facilities Loans and Grants Dollar threshold used to distinguish between Type A and Type B programs $750,000 Auditee qualified as low-risk auditee? Section II Financial Statement Findings matters were reported. Section III Findings and Questioned Costs for Federal Awards matters were reported. 4

7 SOUTH CENTRAL REGIONAL MEDICAL CENTER Summary Schedule of Prior Year Audit Findings Year Ended September 30, 2017 matters were reported. 5

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